With her back against the wall personally and professionally in the Season 3 finale, Jackie escaped both crisis when Akalitus (Anna Deavere Smith) tossed a urine test that would have revealed Jackie's addiction and her husband, Kevin (Dominic Fumusa), confessed to his affair instead of knowledge of his wife's romp with Eddie (Paul Schulze).

This season, Jackie will be confronting her demons head-on and going to rehab. It's a big push forward that showrunner Liz Brixius explains comes under the guidance of new Showtime Entertainment topper David Nevins.

"The way that we had done Jackie for three years was to plant seeds and then nurture them and then they'd payoff in the big finale," Brixius tells The Hollywood Reporter. "People got used to that. David said you've got to pay stuff off."

With a truncated 10-episode season (down two from its previous runs), Brixius went back and watched all five seasons of the Nevins-produced NBC/DirecTV drama Friday Night Lights as a guide for Jackie. "I watched how fast the storytelling happened, how things were setup and there would be a payoff; it happened so many times in the seasons."

The impact of the storytelling approach is felt this season with a quicker pace packed into a shorter episode count that still packs the same emotional punch of its three previous seasons.

"Season 4 is the truth of an addict," she says. "You go for as long as you can and then it's like a house on fire and it all hits the fan. We're covering 12 episodes in 10 and paying off all of the consequences of Jackie's behavior."

During Sunday's premiere, Jackie comes face to face with her addiction and makes the decision to head to rehab after a hard night of partying with a stranger -- played by Green Day frontman Billie Joe Armstrong.

"The last thing that I wanted was to do a show where I’m playing an addict and it's all just fun and games," Falco tells THR. "[It] sort of inadvertently gives the message that addiction is fun and that recreational drug use is a cool thing. So, it was very important to me that there be ramifications. It had to go this way. This way or she had to die."

But going clean and sober won't change Jackie too much, Falco warns, as the troubled nurse will struggle with how to face her daily battles without popping pills. "She's still her, but she's on shakier footing now. She doesn't quite know how to get through the days in a way that's familiar. There will be some adjustments."

Adds Brixius: "She's sober all season and anybody who wondered whether or not Jackie would be interesting sober will find out that she's actually more interesting sober."

Elsewhere, Jackie won't be the only one facing the consequences of their actions, as Akalitus will contend with a new corporate boss in Bobby Cannavale's Mike Cruz after a multinational corporation buys the hospital that will see the former top dog face the music of her misdeeds and Eddie will have to contend with the ramifications of both providing Jackie drugs and his tryst with Kevin's wife.

"Everybody has to pay for what they've done," Brixius says. "Akalitus cheated for Jackie and Eddie was lying for Jackie and they pay the price."

How do you think Jackie will handle sobriety? Are you looking forward to seeing how her world crumbles? Nurse Jackie's fourth season premieres Sunday at 9 p.m. on Showtime.